MOC® (or some bizarre, fractionated form of MOC® rebranded as "continuous certification") continues with all its lucrative trappings.
Now a new, tactic is unfolding to end ABMS time-limited certification nationwide: litigation.
A new free-to-join non-profit was created, run by a multi-specialty group of working physicians from across the nation (disclosure: I'm a co-founder). They created a GoFundMe page to fund anti-MOC litigation that has already raised over $200,000 and is supported by over 1000 physicians (and growing).
In light of the ABMS boards ignoring working physicians' demands to end MOC®, or even allow a meaningful alternative to MOC®, physicians across specialty boards have felt empowered to initiate litigation against time-limited certification. Rather than thinking of this as doctors suing other doctors, it is more accurate to say that this is doctors taking a collective stand against insulated, self-elected, answer-to-no-one bureaucratic bodies; organizations that hide behind humanistic slogans while churning billions of hidden dollars for themselves.
The recent litigation timeline:
- 6 December 2018 - The first class action anti-trust lawsuit against the ABIM - the largest ABMS member board - is filed.
- 23 January 2019 - The ABIM suit is amended to include racketeering and unjust enrichment claims.
- 26 Feb 2019 - Yesterday, another class action antitrust suit on behalf of approximately 25,000 US radiologists was filed in federal district court in Chicago against the American Board of Radiology.
ABMS and its member boards may claim to be nothing less than "a selfless ministry" in the service of medicine and that these lawsuits are frivolous, irresponsible, or even unprofessional. Nothing could be further from the truth. Those on the front lines of patient care fully understand the time and cost involved. But you can be sure of this: litigation was not the frontline physicians' first option. Far from it. All other less time-consuming and expensive alternatives have already been exhausted.
To paraphrase Theodore Roosevelt, justice consists not in being neutral between right and wrong, but upholding the right against the wrong. All working physicians should climb off the sidelines and join this fight to end the unproven MOC® and "continuous certification" programs and recognize the legal battle against MOC® for what it is: not a campaign against continuing medical education, but rather a campaign against the massive runaway train of economic exploitation, self-enrichment, and micro-management of our professional lives that are now the hallmark of ABMS and its member boards.
-Wes
Addendum 6 Mar 2019 - The MOC® legal battle now includes the American Board of Psychiatry and Neurology, too.
80 comments:
Well put. And it's worth repeating again that the loudest proponents of MOC do not participate in MOC themselves. Dr Cassel Dr Nora are two of these MOC hypocrites. Dr. watcher revised himself forc17byears until the optics became too glaring before participating in MOC
Dr Chaudry has never recertified either. Hypocrites.
You are so right, Dr. Wes, to point out that the ABIM and other member boards under the ABMS umbrella hide behind humanistic slogans when their real work is not charity, public safety, or quality assurance, but rather churning, churning, churning, turning out billions of dollars for themselves and their business partners.
It is maddening and sickening to see ABMS' bogus responses to real life suffering of patient and physician.
ABPN was sued too.
So how do we include the ABFM?
The simplest explanation for the uselessness of the MOCs is the fact that all successful Board Certificate holders from a certain point in the 1990's and BACK were "grandfathered". I remain extremely angry at myself for failing the Boards for Psychiatry three times from 92 to 95 and having to take and pass in 97. Hence, I had to do the MOC in 2007. Was simply another Part 1 exam, but the time it took to study and take were useless. Any of my collegues that were fortunate to pass before 94, I think, never have to worry about the Boards again.
I moved to NZ to get away from the Crazy. My 30 years of experience is honored here.
Have the court cases focused on the fact that the ones whom have the oldest training are exempt? Or is it the fact that they run the business now that they are free of it while the younger physicians have to keep paying their bills.
I took my last ABIM exam 2 years ago [I passed]. Fortunately it will be my last [retiring]. I have spent tens of thousands of dollars with study courses, mksap, and exam fees, with additional dollars lost missing work and travelling to and from board review conferences. Hoping a class action lawsuit might give me a refund for at least some of it just on principle Thank you for fighting on everyone's behalf.
I was one of the first to be certified by the ABA in Pain. I also got ABPM certification, and even renewed them once. I got Addiction certification in 2003 and renewed in 2013. The Hospital I was at, and the main insurer that represented 40% of my business, used the fact that I had let my boards lapse, to throw me out of network and establish a monopoly in 2016 (Boards lapsed in 2014) and then altered their bylaws the remove me from staff in 2018. I still am able to do procedures at a Surgicenter and at my office, but just recently a patient was admitted to their sister hospital ER. The transfer nurse called to ask if they could transfer to me, and I told her I was not on staff at any of their hospitals. There is a back story to this. I am an examiner for the state, and intervened on one of the Hospital’s contracted physicians for alcoholism. It was shortly after that the problems started. As well, the Medical Group offered and committed to buy my practice, then got an offer that included possibly kickbacks to the higher ups, and they reneged on their offer. I could have sued but did not. I also noticed that when I last took the 10 year Anesthesia Pain exam, there were many questions where their answers were impossible to answer if one practices ethically. You see, the Pain field has been consumed by the interventionalists, who have even published fraudulent articles to support their stance. I could go on and on, suffice it to say, MOC is garbage, it is abused, and is all for money.
Call Philip Curley- he will file
When are you going to go after ABFM? Start a fund for that.
And what about the American Board of Orthopaedic Surgeons? I finished my residency in 1984, the year ABOS started limited certification. I couldn't take the certification exams before I had been in practice for 2 years. In 1986 I went to Chicago to take 3 exams---the written and oral exams for certification and I had been randomally selected to take a practice-based oral exam that the board was deciding about using in place of the oral exam as they had it at the time. Needfless to say I failed all 3 exams but eventually became certified in 1988. I recertified multiple times, as required---every 10 years---until the end of 2018 as I had previously decided that I was never taking another exam because I would be retired (almost 82 years old since I went to medical school at age 38) and I had had enough even though I still do some non-patient related medical work. During my active years I was also an oral board examiner. My feelings about MOC is that it is a way to make money for the organizations and gives little, if anything, back to the practicing physician. Why couldn't we all have unlimited certification and just submit CME courses to show we are keeping up with our fields?
The ABS definitely needs to be included!!!
Amen Dr.Wes. Thank you.
Hopefully the ABS will be the next to be sued!
They have been scamming surgeons for years.
I am happy to contribute a significant sum on money to litigate this...
The number of similar organizations has proliferated madly. There's certification for giving DOT's, JCAO, for being a doctor in a nursing home and
https://pacificlegal.org/missouri-hair-braiders-are-not-cosmetologists/
There are zero laws, guidelines or standards for any of these.
Obviously what is needed is a professional organization to oversee the other professional organizations. Starting with ethical guidelines against plain pocketing the money.
Interested parties should contact
gmail@nerdpocalypse.net
Don't forget ACOG. As well as physicians putting their careers at risk doing free ER coverage at the benefit of the hospitals. Cover ER or else you will not be given privileges. That sounds like a mafia move as well. Also discrimination with some specialties being paid while others are not.
I agree fully! The American Board of Neurology and Psychiatry is a racket. I just took my recert. neurology exam ($1,400) and will take the sleep medicine recert. exam in November (another $ 1,400). How about getting a life time certificate and send CME certificates every few years to show we are keeping up with our specialty?
i can understand taking the boards once after you finished your residency.if one has taken the boards in internal medicine before 1990, then you did not have to take the boards unless you choose to. this is all started after 1990 because of the new revelation by ABIM that those who were already certified once after finishing their residency have to keep taking them every 10years again and again. how is that the internists in neighboring Canada or in UK and Europe do not have to take boards repeatedly once they have done it once. does that make them less competent than the American counterparts? i strongly feel that ABIM should go back to the rule before 1990 so that the internists do not have to repeat their Boards after their first successful attempt. Joseph Premanandan.M.D.FACP
Why can't we just not support these MOCs? I, for one, am not participating. And I did not take my subspecialty boards and don't plan to. If we stopped participating in this scam it would end quickly. Only our egos support the scam.
I agree entirely,
MOC has always been a solution in search of a problem. Now it's a problem with one obvious solution - get rid of it.
While those who run the individual boards represent themselves as protectors of patients and doctors, they are in fact hard ball players who have used their power to subvert the will of their members. Take for example the tactic they used some years ago to coerce state licensing boards to require MOC as a requirement for obtaining a medical license. When I asked our president if the American Board of Dermatology supported this effort I was told, yes, and to get used to it. Period. Not quite. Within months, working with local leaders we were able to get our legislature and governor in Utah to unanimously pass a law forbidding our state licensing board from using MOC in any way in the licensing process. We were the first state in the Union to put a stop to MOC-mail, and we did it out it the open.
As we all move forward to get our voices heard we must keep in mind that our so called thought-leaders are not always thinking of us or our patients, and we should be vigilant in finding out just who and what they're really concerned with.
Massive refusal to pay or take exam as taught by MLK. Country can't function with only educrates in Academia.
Some states like Texas has already provided relief.
It’s about time. The ABFM should be next.
Recertification is one thing but expensive and time-consuming MOC exams which have not been shown to significantly increase recertification pass rate have got to go. Between electronic health records, MIPS, MACRA, P4P Data collection, expanding health screening requirements, the ever-changing game of coding, increasing overhead and decreasing reimbursement, physicians have enough to think about.
Why are al these comments posted by Anonymous??? That is one of the reasons why the specialty boards and the State PHPs and medical Boards get away with actual abuse of talented physicians who become targets of their puny stupid ego driven wrath against which we have virtually NO protection. A street sweeper enjoys the Constitutional Right to Due process. Go to Med school Devote your time, money, passion and spirit to helping people and you end up destroyed;
I am not ashamed to include my name!
Sarah S. Reade, MD
MSU class of 1992 AOA
There are too many unidentified comments. I think that part of the reason we are so abused by these boards is because we have been intimidated and unjustly punished for acting morally and ethically. The good out weigh the bad by substantial numbers, but once we see the abuse that is let loose on physicians we become like sheeples. Stand up and fight. We are uniquely bright and gifted.
It is unjustified that we should be pushed into untenable positions. A streetsweeper with no degree enjoys Due process. Go to med school, invest your money, time,passion and talent and lose those same rights the Constitution is supposed to allow us to enjoy. The abuse needs to stop. I am not Anonymous. My name is Sarah S Reade MD. My passion and purpose were put on trial. I lost and so did my patients. It is a travesty.
The American Board of Urology bowed to reality and backed off last year, and there is no more high-stakes recertification exam. Basically everybody passes and the exam is used to identify areas that need further CME are identified. It isn't a very good system, because the testing modules that we have to select from are randomly arrived at--why do robotic surgery and stone metabolism go together? Who knows?
There is still a lot of busy work that is time-consuming and that duplicates requirements from state medical boards and hospital credentialing committees, but it is a recognition of the reality that we are fed up. I suspect they will not be sued, since there is little for urologists to gain.
The other thing that I was pointing out to my adult kids recently when they were quizzing me about the process I am going through (my second recertification), is that basically all ABU members are academics. They are in various academic conferences all the time in their university setting, and just like us when we were residents, they passively absorb the information that appears on the exams written by other academics.
How do we include the ABFM
Include the American Board of Physician Specialists (certifying branch of the American Association of Physician Specialists) and you will gather even more support. They have a very egregious and self-serving limited certification (8 years) and require attendance at their national meeting and other costly fees with their Home-baked CME and retesting.
I had 2 change careers because of a medical problem that forced me to five up surgery. I am board certified in ophthalmology which is lifetime, however after not passing part 1 of the ABPN twice, once for the psych part and once for the neuro part, and being refused info that would allow me to challange some questions which I felt did not have a correct response (I also did some formal neuro residency) I have taken what many consider an extreme position. The boards were originally proposed to show additional credentials in a field, not as a method of exclusion, and I now refuse to take any further examinations, but do maintain ongoing educational activities which are pertinent to what I do in medicine. I am 76 yrs old and intend to continue in psych as long as I can and never retire. If you really have the fortitude, start a lawsuit not allowing hospitals to exclude anyone wha has completed an approved residency and is lcensed by th state the practice in. The state licensing any physician to practice any field of medicine without a residency in a field which is probably a bridge too far. The only requirement for practice in a specialty should be th succesful completion of a residency which should be certified by the chief of th residency program with input from the other training staff members who actually familiar with the physician and his competen y
Every one of us physicians must en masse stop feeding this, stop being sheep and stop being cowards. Your patients don't care about this. PA's and RNPs are setting up independent practices, wearing white coats, and taking insurance. They don't do MOC and they're fine. Stop giving this mafia money, watch it die. Stop the fear mongering and stop running on treadmills set to ever faster speeds...hospitals and "the system" will implode anyway, let's agree to make it happen sooner by taking a principled stand and refusing this crap.
The American Board of Pediatrics has been doing MOC for a while. Most members love it! The board exam for pediatrics is one of the hardest yet we are not complaining. What is wrong with having continual certification. It forces us to read and keep up to date.
Board Certification in Ophthalmology is NOT lifetime. Everyone who was certified after 1992 must pass it again every 10 years to remain certified by the ABO. I first passed it in 1992 and everyone before my class is grandfathered in. I have no intention of taking it for the 4th time when I am 63 years old and nearing retirement, that is ridiculous when those who graduated 1 year before me have never had to recertify.
All this should have been done years ago when these ABMS morons came up with this scam. Meanwhile, the ones running the scam have lived like kings and queens off the backs of hard working physicians. Disgusting, arrogant, hypocrites all of them. Hope they can be shut down forever. They should all be prosecuted under the RICO act and be perp walked to the DOC bus for all to see. I retired from medicine a year ago, this MOC crap was a big part of my decision. I've never seen another profession get kicked around and abused like the medical profession. It's time we all band together, maybe form a union, and start taking back the power stolen from us years ago by the suits in the ivory tower. Be well, fellow physicians, best of luck
AGREE 10000
THE SYSTEM IS JUST A RIPOFF ON NAIVE PHYSICIANS OF USA,AND PUT US DOWN ACROSS THE GLOBE
NO OTHER COUNTRY OR PHYSICIANS ORGANIZATIONS ALLOW THIS TO HAPPEN TO THEM,ONCE YOU ARE BOARD CERTIFIED
THAT IS FOREVER EVEN IN THE WORSE COMMUNIST SOCIETIES
I AM 4 TIMES BOARD CERTIFIED IN MY SPECIALTY SO I USE THAT TO ADVERTISE MYSELF SINCE I WAS FORCED TO TAKE THE BOARD (AS I CONSIDER MYSELF} BECAUSE NOT TAKING IT BESIDES THE HOSPITALS OR INSTITUTIONS PUTTING YOU DOWN,
REMOVING PRIVILEDGES,NOT ACCEPTING YOU IN THEIR STAFF,OR LAWYERS USING AGAINST YOU WHEN THEY DO NOT HAVE
TO DO THE SAME,IT IS TERRIBLE,DEMORALIZING,CREATES PAIN AND SUFFERING,DESTROYS EVEN YOUR PRACTICES,YOU LOOSE ECONOMICS IN A TIME WHEN WE ARE BEEN DESTROYED ECONOMICALLY BY THE SYSTEM.
THESE BOARDS CREATE PAIN AND SUFFERING,DESTRUCTION,AND ARE GOOD FOR NOTHING,ANY REAL SYSTEM WOULD BE FIGHTING TO CREATE A FREE KNOWLEDGE ACQUIRING ACTIVITIES SCIENTIFICALLY PROVEN TO FUNCTION,MANY AVAILABLE,THE PRESENT ONE DESTROYS US FROM ALL POINTS OF VIEW,IT IS CREATED FOR THAT,IT IS A VERY LUCRATIVE POISONOUS ,I SEE IT AS THE ABUSED SYNDROME,STOCKHOLM SYNDROME,OR COMMUNIST SOCIETY SYNDROME WHERE THE ABUSED BELIEVES THAT HE DESERVES IT,AND LOVES HIS ABUSER NO MATTER WHAT.
FOR THE ONES THAT HAVE SEEN “THE ADVISES OF ASCLEPIUS TO HIS SON WHO WANTS TO BECOME A DOCTOR” IT IS
MORE CLEAR TO US THIS,WE DESTROY OURSELVES.
FOR THE ONES THAT HAD STUDIED PAULOVS EXPERIMENTS AND MANY OTHERS PRACTICED BY TYRANNIES LIKE COMMUNIST SOCIETIES UNDERSTAND WELL WHAT IT IS BEEN DONE TO US SEE EXPERIMENTS OF MARTIN SELLIMAN....
AT THE END IT IS MAKING MONEY ON THE NAIVE AND NOBLE PHYSICIANS BY OTHERS EVEN COLLEAGUES THAT SHOULD NOT BE CALLED THEMSELVES DOCTORS,IT IS HUMAN NATURE AND YOU SEE HOW MACHIAVELLI WAS RIGHT HUMANS ARE BAD FIRST THEN WE BECOME SOMETHING ELSE ACORDING THE ENVIRONMENT WHERE WE DEVELOP OR SIMILAR.
NO OTHER COUNTRY AFTER YOU ARE BOARD CERTIFIED ON YOUR SPECIALTY DEMOTES ANY PHYSICIAN FOR NOT RETAKING UNNECESSARY EXAMS THAT PROVES NOTHING,EXAMPLE YOU MIGHT DISCOVER THE CURE OF ALL CANCERS AND FAIL YOUR INTERNAL MEDICINE BOARD UNNECESSARY TEST BECAUSE YOU DO NOT TREAT URINARY INCONTINENCES.
STOP THE ABUSES OF POLITITIANS,GOVERNMENT ,HOSPITALS,AND ,SO CALLED DOCTORS THAT ABUSE REAL DOCTORS.
I agree with all. I also have noticed no objecting comments from anyone supporting the MOC! I have certified and recertified with the American Board of Internal Medicine. But I refuse to recertify again in 2021, when I'm due. My last certification was a joke. I continue to keep abreast of my field. I have received more than enough CME's. I feel as though this is more than adequate. I'm only 53 and still have a few good years of practice ahead of me. But, I will not participate in this scam any longer.
Steve J. Arvanitis, MD, FHM
Assoc. Dir. Inpatient medicine
UnityPoint Trinity Med Center
Rock Island, Illinois
The pediatrics board allowed pediatricians to be grandfathered in one year prior to my husband who finished his residency in 1987. How is it that pediatricians before 1987 are somehow competent to practice without being required to recertify? That is BS!! Once we finish medical school and residency and get a license, that should be enough. Most physicians are quite self-motivated and OCD enough to make sure they stay up to date with CME in the areas of medicine they treat or are most interested in treating. Enough of this crap.
I really do not see the huge issue with the MOC. I do a few MKSAP and nephsap questions and take study for an exam every 2 or 10 years (my choice). They got rid of the silly practice improvement nonesense and they allow for CME to count toward MOC. Where is the problem here? I never understood it
The worst part of MOC is that some hospitals and insurance companies use it in determining payment schedules and participation. In other words, no certificate, then you are off the staff. I would suggest we start making the certificate worthless, then and only then, would the boards listen because most docs will not take an exam if it has not worth.
As noted above, this is SOOO much bigger than ABIM. It affects ALL of us.
I am certified by the American Board of Radiology and have been since the 90's. Since certifying, the rules and requirements for maintaining my certification have changed almost annually. Three years ago, I took what I paid for to be my LAST 10 year certification exam. Given my age, that would have been my LAST certification exam before retirement. Paid for it. Passed it. So glad to get off the merry-go-round. But no, that year the ABR decided yet again to switch horses in the middle of the stream and initiate yet another NEW program.... eliminating the 10 year certification and instead going to on-going exams. Three years later, no one really knows what this is going to look like. But change the rules, then look at the consequences.
SO I paid for (and took and passed) a ten year certification which the board then decided was in fact good for only 2 years. I have yet to received any reimbursement for the other eight years of certification I paid for. Hmmmmm.... how is this even legal??? If I go in and pay for a car in full, I do not believe that the law would allow the car dealership to come and reclaim the car that I had paid for after 2 years because they arbitrarily decided to do so. But apparently the Board can. The Board can do what ever they want. When ever they want. Regardless of what they have promised or I have paid for.
And they can do all this under the banner of improved patient care????? That is how they get patients and payors on board. But this is the era of "evidence based medicine". Where is the evidence that all these change or in fact ANY of these changes to the board certification process, improve patient care in any way, shape or form? Like the old commercial...."Where's the Beef?" As a locums licensed in multiple states, I have huge demands to meet CME requirements upwards of 40-50 hours/year. The cost to me in time, actual cost and lost income is huge. But I can see the benefit in a lot (although certainly not all) of the CME requirements. But quality projects, to maintain my certification???? When I ask at multiple national meetings how I was to do a project as a locums, I was told to either count cars in the parking lot to make sure that patients had enough parking or to give my client physician a report on how they could improve their practice. Seriously. I would like to say this was a joke or that I was making it up, but its the honest truth.
Make constant changes to the rules, charge a lot for these changes which are all borne by the physician diplomate without a voice, hold this board certified quality physician's ability to continue to ply his/her trade as a the carrot on the stick, do not evaluate whether the changes impact in any way shape or form on patient care, but if you completed your board exams the year before I did, than you have absolutely no obligation to participate.
If this is about patient care and anything had been done to demonstrate that boards improve patient care, why is ANYone exempt????
Doctors have brought this on themselves. By slavishly bowing to board certification as a means of personal and professional validation we have given our oppressors the club they need to beat us and we have even paid them to do it. Somehow board certification made us better doctors. Sure, hospitals and insurance companies now demand it but that only started in the late 1980's early 90's.
I practiced without the boards for 30 years and only recently took the IM boards because after decades they again changed the rules and threaten to time out eligibility in 2019. Since 2016 I've been certified but I do not use it in any of my credentialing. I check the 'no' box on the applications or leave it blank. All of the insurance companies that have required board certification accept me without it. So have the hospitals. What they say and what they do seem to be independent.
It is funny that the ABIM had $78 million in addition to luxury condominiums. The cash has been moved to accounts in the Caymans, oddly just before the first lawsuits surfaced. That $78 million came out of the hides of the doctors whom they oppress and abuse.
I for one passed my internal medicine boards in 1984 and thus was grandfathered in. I work in graduate medical education and see innumerable medical residents paying huge fees for a host of internal medicine board online study courses. Many are intimidated and I do not believe that the passage of a recent "adjunctive" test to demonstrate that a physician can "cram" to pass a theoretical certifying examination means anything in regards to patient care. There is actually no substitute for intuition and decades long experiences in the real world of patient care for one's specialty. Whatever happened to the requisites for CME in the arena of one's specialty to continue to be in good standing after one has passed their certifying board examination? I for one am sick of the innumerable "credentialing" that one must undergo in order to see a patient of a particular insurance plan. This is absolutely ridiculous as the other processes for licensing we go through mean nothing and we all become slaves to the 3rd parties of insurers who demand these additional "certifications" to see their clients. I can tell you for certain, that I have talked to my patients about what MOC is and no one from their side is aware of this "re-credentialing" process, feels it is of need and from my clients perspective the most important thing is one's years of actual practice experience and maintaining an open minded attitude towards incorporation of new methodologies in patient care: easily done by attending conferences of your choice that provide commensurate CME. We all have way more than enough to do and the fact that MOC demands additional after hours for studying, the fear and need to pay for online courses to pass this examination along with the costs of the test itself, implies that we have no life after work and that they (administrators) could care less.
Suits demanding the abolishment of MOCs must include a demand that the various boards must re-instate all expired timed certificates. I am grandfathered by the board of plastic surgery but strongly feel that MOC is counterproductive and abusive and more importantly irrelevant, contrary to the initial board cerificate after finishing residency and passing the required exam.
Agree with everything. The ABOS also needs to be sued. I received my first Orthopaedic certification in 1997 and have recertified 2 times. I’m thinking about retiring sometime in the the next 10 years. The test is a money grab which is extremely expensive and time consuming. 10s of thousands of dollars have been spent over the years. Now I wrestle with whether I should go through this again for the 4th time in 2025! I may be retired but it would be nice to keep my options open in case I want to work more. The “old guys” that are working now, that are the furthest from training don’t have to do this!
The issue today is the same throughout history. Shall a man be allowed to govern his own life or be ruled by a small elite. -Thomas Jefferson
The MOC would be more palatable if all were subject to the same. No exemptions. The very definition of corruption is when some are more equal than others. And when unelected bureaucrats have the power to arbitrarily determine the destiny of an individual we have injustice. Those injured by injustice will naturally seek remedy. Many thanks for lending your courage to speak! -Qanon.pub
Roberto Illa, M.D.
I have been life certified since 1976 by the ABIM. They tried to get me to retake the exam. I refused. You should know that the California Medical Board is doing the very same thing as the ABIM etc. After 43 years of practice, they suspended my license for three years. I was not sued by anyone, nor did anyone claim I injured them. I had to close my office. They posted a false Accusation on their internet site since 2016 saying I was "incompetent" and that the diagnosis that I gave a patient as a second opinion in 2014 "probably did not exist". This diagnosis was "Nesidioblastosis". First described by G.F. Laidlaw in 1938. There are over 500 citations in the U.S. National Medical Library (www.pubmed.com). I was sending my patients with this diagnosis to UC Davis, Dept of Surgery, Sacramento, where Drs. Hirose and Bold make this diagnosis several times per month. As a result of their false posting (violating Business and Professions codes 2056 and 2234.1) I have not been able to get employment for the better part of three years. So they have driven me into bankruptcy. I filed a lawsuit against the Board in Feb of 2018. As in your case the judges have decided in favor of the Board and ignored published law. These are my case numbers in Sacramento Superior Court: 34-2018-80002974. 34-2018-00227175. No attorneys will take my case. The majority do not even answer my phone calls, e-mails or letters. I have written the AMA, CMA, ACLU, FBI, U.S. Attorney General in San Francisco, and all of my State representatives (including Gallagher). No one has offered to help, if they even reply. I have spoken to two other male physicians who have been attacked. Huge "fines" are extracted. ($ 30,000 to $ 50,000). "Supervision" and periodic "testing" is carried out by a Physician's Assistant. See my website at www.BloodSugarDisorders.com. I have been an international speaker and self-published several books in this field. The Medical Board functions without ANY oversight. Apparently, the all powerful Kimberly Kirchmeyer, the Executive Director, is a cosmetologist, not a physician. Their operation is in violation of the Federal RICO act. As in your suit they are doing "racketeering" and the money just disappears. They even "sealed" my case. This gives them the right to destroy the record of the OAH "trial", in which my main evidence (lab work) could not be introduced.
I am older Pediatrician but NEVER certified but has kept my CME and self study in weak areas and nor doing beyond my expertise. Time and Cost is a deterrent for certification and does not make us better PHYSICIANS. Is another way to extract FUNDS and support a bureaucracy with minimal real improvement. Sued once and was dismissed. Never have a malpractice, nor punished by any hospital but several of my friends that were BOARD CERTIFIED have been. Unsure how we can assure we are capable by passing a test that will have little resemblance to a true patient. AS far am concerned BOARD CERTIFICATION is not worthy. Thank you
DR WES, keep it up. Dr Villalta
I think the best way to resist MOC is to cancel your society membership. I have decided to cancel my ASN membership as all societies are in collusion with ABIM in terms of offering board review courses and profiting from this useless exercise to prove your competence. If enough physicians do this we will see a meaningful change in MOC.
dear Dr.Roberto,if you have been board certified by ABIM in 1976, you are not required to retake the Board exam unless you want to.only those who taken the Boards since 1990 are require to take the board exam in internal medicine every 10years and i do not agree with this requirement either. it looks like you are wrongly targeted .how is that in our neighboring Canada, this is not a requirement or in UK or in Europe. Does it mean that our counterparts in these countries are less competent than the internists in Us.
Surgeons should file class action suit against American Board of Orthopedic Surgery! The Board, like all others, is about enriching few individuals and have very little to do with safety of patients or advancement of technology. Here are my reasons to advocate such action:
1. After passing the Part I examination first time, I failed the Part II examination twice, and prevented to take the exam the third time! I had trained in orthopedic surgery in Britain before I came to the USA and repeated my orthopedic residency, after fellowship in spine surgery. I asked the Board to explain to me why I had failed twice, despite the fact that my patients were doing so well. I did not get any answer. So, I asked one of the Professors, with whom I had trained why I was in such a situation. He advised me not to perform any complex surgeries, such as fusion of the spine, until I had passed the Part II examination! What I found shocking in the advice was that, in order to pass the examination, I had to avoid the surgical procedures which would form the major part of my practice after Board certification! Think about that! By the way, I had taken the Royal College of Surgeons in Britain and passed! There was no way I could pass that examination by avoiding difficult cases, because the examiner would, most certainly, create a complicated scenario and demand to know how I would manage it – the patient would be the examiner him/herself!
2. For Part II examination, I would collect cases over 12 months, and submit the list of the operated cases out of which 12 would be selected for presentation at the oral examination. If the examination was about evaluating my competence as orthopedic surgeon, rather than asking me to present cases which I had hand-picked and procedures I had performed over twelve months’ period, the examination should create the problem during the oral examination and evaluate how I would go about be solving the problem – my patients do not warn me twelve months ahead of their ER visit, with open fracture of the tibia - I have to make diagnosis and plan treatment on the spot!
3. After failing twice, not getting any answer as to why I failed, and being prevented to sit of the exam the third time, I hired an attorney and threated to sue ABOS! They panicked, reversed their decision to bar me from taking the Part II again, and allowed me to present the same list of patients I had presented previously! I passed the exam the third time, using the same arguments I presented the previous time!
I completely lost respect of ABOS, and I resolved not to subject myself to such a insult again! The world community of surgeons in my field know me for what I contribute to advancement of technology in my field, not because of ABOS! I will be happy to testify in a suit against ABOS, and I am sure there are many who have suffered similar fates in the hands of ABOS! The Board has damaged me and my family, but we all owe it to ourselves and future generation of surgeons to get rid of such scam!
I am Dr. Arch Miller, board certified Plastic Surgeon. The process began in early to mid 80"s because of litigation against physicians. It was designed initially by legislators and attorneys to make the weak incompetent doctors like all of us to take meaningless exams to "prove " our worth, and that the "dumb " ones would be weeded out right away.This does not apply to attorneys, or pharmacists, or engineers, or any other highly professional technical fields. Why Doctors??? Because we do not protect our own. A union would stop all this. It is our own laissez-faire attitude that got us here. I do 50 plus CME's a year for maintaining certification. that seems enough.
I feel that this is a great thing and am sorry that as a recent mostly-retiree I won't be seeing any benefit. One thing I have begun to realize is that there are a lot of credentialing "rackets" that don't involve the specialty boards. It's amazing how much EVERY credentialing entity has their hand out for a kickback. Massachusetts, one state in which I'm licensed, decides every cycle that they want physicians to learn something ELSE before renewing their license. I'm in a specialty that almost never sees death and when I do, it's sudden and unexpected, yet I have to do CME in end-of-life care. My other state, Florida, requires us to pay into some obstetric complication fund, and I think some other kickback was rolled out this year. That's all well and good if you are full-time and making 600 grand a year, but if you're just maintaining your license wanting to pick up a little part-time work in primary care, it really makes it not worth bothering keeping everything up.
Unfortunately the Hospitals have bought into this. Many hospitals, including mine now require current board certification. If certification lapses you will loose your hospital privileges. Our hospital has also excluded using other certification options or boards. There is nothing to stop hospital credentialing from doing whatever they want and it is easy to get it passed through the medical executive committees - most of which are run by physicians who are grandfathered in. When I first took IM Boards I was told it was not to be used to exclude privileges or a physicians ability to practice, it was supposed to be a sign of excellence. What a pile of crap. Clearly a system to make money. CME is relevant to practice. MOC is a joke and should be eliminated, nothing else will be acceptable. I likely will be forced to take it once more, due to hospital policy and then I will not take it again, I will retire first.
Whoever wrote that pediatricians love MOC has lost their mind. I'm a pediatrician and I have NEVER HEARD OF ONE pediatrician excited to give their money to ABP and their million dollar salaries, lack of transparency, and completely irrelevant activities. I wish the pediatricians would follow their ABIM brethren and follow suit. Crazy the amount of money we are paying!
I am glad my fellow physicians are now fighting these people. However, as you can see from my post above, the Medical Boards and specialty Boards are operating outside of the law with the help from the courts. I have heard some of my colleagues say that we have "brought it on ourselves" or we should have resisted sooner. However, the cost of fighting the Medical Board, the Office of Administrative Hearings, and the judges of the Superior Court who are abetting these scams, is enormous. The quote I was given, as a deposit for the (Kangaroo Court) OAH hearings was about $ 30,000. The OAH court is not part of the California judicial system, but a private corporation, paid by the California Medical Board. It cannot override the decision of Kimberly Kirchmeyer, the Executive Director of the Board (and cosmetologist). And they don't try. So, what has happened to me can happen to any doctor in this country. That is, you can have your license suspended or revoked for no reason and your appeal through the Superior Court illegally blocked. Recall that I was "disciplined" by the Medical Board in violation of Business and Professions Codes 2056 and 2234.1 which basically says you can't punish a doctor because you, as Administrators, disagree with his/her diagnosis, IF no harm was done and the patient was not placed in danger. My National Practitioner database report is still clean and even ABIM refused to strip me of my Board Certification even though the California Medical Board asked them to do this. The Medical Boards, as I said, are able to operate outside of published law and extract large sums of money from doctors pretending to be "protecting the public health" from "bad" doctors. All of us are defenseless in the face of a corrupt legal system.
Agree that the person who said the pediatricians love MOC is lying... I have been practicing in the field for 26 years and have NEVER met a colleague who doesn't HATE MOC... The whole MOC program is nothing short of racketeering, with Board Certified Pediatrician forced to hand over thousands of dollars so that we can still be Board Certified Pediatricians... If the program was FREE, then I might be able to see it as some sort of enlightened program to help keep us all up to date... but it isn't, is it?!?! You have to go to the ABP and do THEIR activities and pay whatever the hell they want to charge you, in order to get qualifying credits - and if you don't, we'll take away your certification and you'll lose your job... Sounds like a racketeering and an anti-trust operation to me...
Doctors shouldn't think for a minute that if their own certifying boards drop recertification, that their troubles will be over. States, or the federal government will step in, create their own ridiculous criteria to maintain a license or certification, and probably charge twice as much.
I am ABFM certified and agree with many of the comments. But a big issue for me is in the details and not just the concept. In concept it is not such a bad idea to certify that a practicing member of a specialty be up to date on their knowledge and practice of their field. But in family practice there are many layers of MOC and not just an examination. While I agree that multiple choice exams are a poor assessment of cognitive ability they do stimulate learning. But many of the materials from the ABFM are poorly written and structured, infuriatingly simple minded or irrelevant busy work. Self assessment modules with questions that don't test what you know or have learned but are derived from irrelevant details of the articles. I have been on test assessment committees for years as an academic dean and wouldn't have allowed such shoddy, poorly planned materials for my professional students, much less for graduate physicians who are paying a lot of money for the privilege of taking this drivel. Many of the modules are enthusiastically applied experiments in getting physicians to study their own practice, using questionable methods. I find I am opting out of MOC, as a semiretired physician I can't afford it and can't afford the psychological stress of acquiescing to a process that reminds me of the arbitrary humiliation we received in elementary school. I would be willing to take an exam as we used to do, but not all these modules that reflect poor methods of teaching or assessment. One point that may have been made already but I don't think I've seen, is that if we have to document our ongoing competence- what about the Boards? What standard are they held to as to the validity of their methods and the correlation with other measures of maintained competence? Not only are they hypocrites for not recertifying themselves as physicians- but what demonstration is there that their methods are sound?
I posted this in the past...but I think it is worth putting up again:
Here is the 2014 ABIM tax filing data. Please also see at the bottom where the ABIM previously covered Dr. Cassel's spouse's travel.
DIRECTOR
( 10) RICHARD J BARON
$516,046 plus $172,015 (from ABIM Foundation) plus $123,945 ("other compensation")
DIRECTOR
(14) VINCENT MANDES
SENIOR VICE PRESIDENT/CFO
$315,410 plus $35,046 plus $41,951
( 15) LYNN LANGDON
FORMER SR VICE PRESIDENT/COO
$328,796 plus 0 plus $55,855
(16) REBECCA LIPNER PHD
SVP OF PSYCHOMETRICS
$373,989 plus 0 plus $52,441
(Pretty good for a psychologist.)
(17) PAUL PONIATOWSKI MS
VP TEST DEVELOPMENT
$297,753 plus 0 plus $59,032
(This master's degree is worth more than a lot of MDs!!!)
(18) LORIE SLASS
SVP COMMUNICATIONS
$272,161 plus 0 plus $66,080
( 19) ELJZABETH BLAYLOCK
SVP PIM DEVELOPMENT
$319,743 plus 0 plus $52,989
(20) LESLJE TUCKER
VICE PRESIDENT OF POLICY
$233,377 plus 0 plus $39,512
Note: 2013 Christine Cassel (former president and CEO)
$741,553 plus $247,184 plus $219,156.
The BEST FOR LAST!!!! The 2013 990 form:
DR CASSEL'S EMPLOYMENT CONTRACT
ALLOWS FOR SPOUSAL TRAVEL THIS ALLOWANCE IS SUBJECT TO ALL APPLICABLE PAYROLL TAXES.
I agree with tis as well. They are all money grabbing machine. I wish we could start some kindof boycott movement where all of us physicians just No! No more exams after the initial one. These overpriced exams do nothing to make us more competent and the prep courses that are using the fear factor to also squeeze out more money from us. If all physicians just stopped taking these ridiculous exams then these organizations would lose their relevance. I am so sick of it all.
This MOC is ridiculous; part 2, part 4, points and so on; taking MOC will not make us better doctors, and not completing them will not make us incompetent. I am so glad this lawsuit is underway. Yes it is a money making racket and need to be stopped.
Hopefully , ABP is being sued too!!!
I only complied as insurance companies (which are bigger money making machines) need physicians to be "Board Certified".
We dug our graves first with going with the insurance companies and now are digging it deeper with complying with "MOC".
I cant wait for the day when physicians unite and file class action lawsuit against insurance companies!!
Roberto Illa, M.D.
Yes. Boycott. I was thinking the same thing. See my post above. My license to practice was illegally suspended for three years, causing severe financial hardship for myself and family. This action which violates Business and Professions codes 2056 and 2234.1 (California) was ignored by the Medical Board. I was not sued and no one claimed injury at my hands. The CME that is offered did not help me in my practice. The large conferences are offered by the University of California system. They are all about attracting referrals to the University (cardiology, neurosurgery etc etc). Very few actually help an internist survive in private practice. The specialty boards and the State Medical Boards are taking in massive amounts of money and operate without oversight. The continuing education and the notion that they are trying to keep us "up to date" is a fraud. The "standard" is created and sold by McKesson corporation. These "standard of care" guidelines used by the State Boards and most hospitals and clinics are outdated. Take the "diabetes" epidemic. We all know there is no "cure", and so there should be room for educated speculation and scientific investigation. I did that. (See my book on amazon.com "Disorders of Blood Sugar"). My book recommends a better method of classification and testing. A doctor, apparently working for the Board told me that if I did not retract the findings of my research as published in my book, I would "never work in California again". Within months I was put "on trial" by the Board at the Office of Administrative Hearings (OAH) in Sacramento. I was not allowed to introduce key evidence (lab reports) that proved I was right, and I was suspended for three years! The diagnosis I made (Nesidioblastosis) has over 500 citations in the National Medical Library (www.pubmed.com). I was referring some of my cases to the University (UC Davis Dept of Surgery). They make this diagnosis several times per month, at least. Yet, the California Medical Board stated in their online "Accusation" that this diagnosis probably does not exist, and, therefore I am "incompetent". If you want to be exonerated you must go through their PA supervised "brain washing" and pay the Board about $ 30,000! Short of arresting all of these Board people and putting them in jail for decades boycott would be our only hope.
There also is a lesser known damage that the Boards have caused: the American Board of Pediatrics required all specialties to become 3 year Fellowships to sit for the Boards. This resulted in far fewer people going into the subspecialties which do not pay as much like Developmental Pediatrics and Adolescent Medicine. This decrease was predicted, but the leaders of the ABP sat up in their ivory towers and ignored the warnings. The additional "research year" meant a longer time before young physicians could start re-paying their debts and added another year of non-clinical time for which the Pediatrics Programs would not get reimbursement. The number of Fellowship slots diminished and the number of applicants dropped even more. Thank you ABP.
I recently re-certified with the American Board of Ophthalmology, and I could not believe the quality of some of the questions on that exam. (an electronic exam that still took many weeks to return the results). There were items that clearly showed whoever was responsible for the exam hadn't updated some of it for years, or hadn't been to a relevant meeting themselves and put the new best consensus medical standard information into the exam. Other shenanigans through the years were complicated and time consuming and added very little to the overall quality of my practice or to that of anyone else.
I think Board certification is important, initially. After that state license and hospital accreditation, personal integrity and the good old free market insist on CME, regular reading and implementation of best practice. Ongoing MOC should go away. Still costs thousands of $ for what I don't know.
Like many commenters, I missed out on "Lifetime" cert in Anesthesia but got lucky in that the American Board of Anesthesia changed to a MOC situation that is more continuous the year I would have had to take a single test. I have to say, the MOCA process was not bad for the first 10 years. Keep up on CME, go to a simulator once every 10 years, do ABA provided on line questions all at a expense that mirrored the "old" way.
However, just like the money grab that I hear my colleagues in other specialties complaining about, the ABA has "continuously improved" the process. Now there are "Patient Safety" CME that need to be completed. And guess what? The high quality CME I've been purchasing through the ABA does NOT now include questions that would cover these new topics - BUT there are new modules available for purchase that "satisfy the requirement"...
I have decided to "opt out" in that I will not pay the yearly fee to be "current" and I have no plan for "re-certification" when the time comes. I just missed the cutoff for lifetime cert and like others I regret it but I also think that certification is really not that meaningful anyway. The fact that you can pass a trivia quiz every 10 years does not make you a better doctor.
It’s about time this has happened. It should have happened 20 yrs ago! šš» Go for it and never turn back.
I am thrilled beyond belief to see so many suits against the ABMS member boards. I lost my certification last year after refusing to pay several thousand dollars to obtain 20 CME's to fill a requirement that was added in the last 2 years of my certification. I had met all previous requirements, and met all the requirements that ABPN informed me I would need to complete when I obtained my initial certification. I would love to agree with the "to hell with them, just let it lapse" crowd; however, I have a passion for administration as a Medical Director for community mental health programs, all of which specify that Certification by ABPN is a requirement for the job. I am currently looking at new positions that I am perfectly qualified for but this one requirement makes me ineligible, now that my certification has lapsed. So too do many hospital inpatient positions require ABPN certification. I have obtained NBPAS certification but this goes unrecognized by all insurances and most hospitals. It is infuriating, having spent upwards of $6000 for my initial certification, which I passed on the first try, to be lost because ABPN kept changing the requirements for recertification during my initial period. And it adds insult to injury to have last minute requirements instituted that cost half the price of my certification, just to be eligible to pay another $1500 to sit for recertification. I hope that the outcome of this forces the Boards to return to a reasonable requirement of annual CME's after initial certification, and that those of us who were once but are no longer certified see our certification reinstated.
I enjoyed CME through Medscape, but they only allow for MOC 2 to ABIM, not ABP - pediatrics. So I no longer use it. I only look for CME that allows for MOC for my Board - so certain course providers that have been 'approved' by the ABP are in, even though their CME might not be as good. Not sure if such organizations have to pay to be one of the players?! ABMS MOC 2 duplicates the purpose of CME...
Also, I've been involved with quality improvement PDSA etc., for over 20 years. The projects are generally hospital or practice based. Now I have to pay the ABP to get the project linked to them so I can get MOC 4 credit. More duplication...
Not to mention that the initial recert exam was open book on your own time - which reflects practice, rather than a one time proctored exam where you had to travel, etc. The whole thing adds a lot of cost, angst, and it reduces the time we actually spend taking care of our patients.
Everyone is correct that the main creators of this were grandfathered in.
The neonatal boards contain a lot of advanced statistics and pharmacokinetics. Not sure what this has to do with neonatology specifically. Not everyone had advanced training in these fields. These should be in all boards or no boards - or there should be training for these areas.
I am in the last Orthopedic class to have permanent. Had to remind ABOS because they took my name off when they created a web listing.
Never took a MOC.
Took Ortho exam 3 times. Took time off from practice to pass.
Passed the written three times. Associate prof's who are sent to Chicago by their Chief's are likely carrying a chip.
CME courses have become expensive because the speakers "pay" is $400 hotel.
Most US doctors educated after 1980 need some more education.
Now cultural classes replace anatomy.
MOC could be staged: Step one, online 1 hour timed test. 90% pass. ID could be witnessed or verified at a hospital. Step two - essay to explain why the doctor is an outliner. In my case the oral examiner was an adversary, that I did not respect.
Whoever posted that "most members (of ABPeds) love it!" is either deluded or on the board. And of course he/she posted anonymously...
What a scam! We're basically being extorted out of thousands of dollars for what equates to a "Good Housekeeping Seal of Approval." But if we don't take it we can't get paid. ABPeds is going away from the proctored exam to a quarterly open book exam. But I am willing to bet they'l want even more money for the "convenience."
My goal is to retire before I have to take the exam again.
Was wondering if they were:
1- misleading the public by giving the impression that board certification indicate better care.
2- indirectly using medicare and medicaid money from the collective dollars allocated for medical expenditure without giving a return for the money spent on them. Money spent on re-certification, off work, attending "board review courses", etc.
3- indirectly giving the public the impression that non board certified providers are substandard in their care.
I am absolutely thrilled to hear this. I declined to give ABPS $1,000 to have them "verify anyone who inquires that you are ABPS board certified", although I have (actually had, I declined to put it up this year) a 20X25 inch certificate on my wall stating the same. Do you realize that's why they don't give you a pocket card stating your certification? One hospital had me take a photo of the certificate on the wall! The push came when I would have had to spend approximately $5K and take time away from business to do their required CME for this year to take written boards in December. The kicker was the letter said something like "At this date, the only way you can get 50 of the 150 required CME to sit for the boards is to take our required course in X which costs X". Felt scary, but I'm not renewing ABPS boards at all. I am still a diplomate of ABIM till 2022 and there is no doubt I'm not renewing that either.
Loved medicine when it was medicine. Thank you for everyone who is fighting this. We were like sheep when I finished my residency, grateful to pass any board at all. Sheep now have blinders off. The medical community as a whole will not tolerate this. I'm so proud; wonder why we took so long. I haven't seen anyone mention it but one fear is med-mal. I can just hear the attorney for the plaintiff bringing up in your depo why you didn't renew your boards. We have to stand together, so that phrase can be meaningless.
As part of discovery, the pass rates by age, sex, and race should requested. If there are any disparities, the exams are discriminatory, and enjoined by a federal judge.
Any hospital or insurer that uses these results should be added to the lawsuits. Their use of interstate means of communications, such as the internet, gives the lawsuits federal jurisdiction over their conspiracies. These are criminal matters. If federal prosecutors refuse to prosecute these conspiracies, a writ of mandamus forcing these prosecutors should be filed.
These are intentional acts to exclude doctors from seeing patients, decreasing the payments to be made for care. They are backed by garbage science, if at all. Such restrictions damages patients. They should join in the litigation. Exemplary (triple) damages are justified. Criminal charges justify long prison terms for the conspirators.
Organized medicine has been worthless. Immunity is justified by the encouragement of a new enterprise, such as a railroad 150 years ago, the internet 30 years ago. Medical insurance is a mature enterprise. The immunity granted it in ERISA should be repealed.
I am a 3 times certified Pediatrician. I and refused to recertify in 2014 because I think that the American Board of Pediatrics is just a scam to suck up the pediatricians money. I was disabled in 2016 and now I am planning to reapply to work again. Now I have being obliged to get into the MOC Pediatrics because all the jobs require you to be BE/BC. I think that the ABP are the biggest SCAM, I am so glad that we doctors are waking up and calling them for what they are!! LETS KEEP IT UP!!
Doesn't Board Eligible mean, you completed a residency in the specialty? You should mention that requiring a test based on garbage science is discriminatory, and not relevant to your ability to treat patients.
Stop screaming (all CAPS).
I passed my board once. I maintain my certificate by doing my CME. Enough is enough!
Psychiatrists File Class-Action Suit Against ABPN Over MOC
MARK MORAN
Published Online:11 Apr 2019https://doi.org/10.1176/appi.pn.2019.4b11
The suit charges that the ABPN has unjustly enriched itself and its officers by creating a lucrative certification product imposed on top of initial board certification.
Two psychiatrists, one of whom is an APA member, have filed a class-action lawsuit against the American Board of Psychiatry and Neurology (ABPN) alleging that its requirements for Maintenance of Certification (MOC) are illegal and anticompetitive.
I passed the ABIM September 12, 1979 and have thanked the Good Lord since. I do some 75 hours of CME a year, and am still practicing. But the fact that I never had to do the MOC farce meant that I had hours to spend with my family, and my well-being not be a victim of this ABM scam. I wish you well in this fight.
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